The use of flumazenil after midazolam-induced conscious sedation

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Abstract
Objective To investigate the use of flumazenil after midazolam-induced conscious sedation. Design and setting A prospective audit was carried out in the Department of Sedation and Special Care Dentistry at Guy's Hospital, King's College, London, 2009. Subjects Patients sedated with midazolam for dental treatment. Method All clinical staff completed the data capture proforma when flumazenil was administered to a patient after sedation with midazolam. Results Four hundred and fifty-three patients were sedated with midazolam. Flumazenil was used in 32 cases. No cases required flumazenil for the emergency treatment of respiratory depression. Conclusions The results of the audit confirmed the safe and appropriate use of midazolam for conscious sedation within the Department of Sedation and Special Care Dentistry at Guy's Hospital and demonstrated that flumazenil use was low and in accordance with current best practice. The audit has highlighted distinct indications for the post-operative use of flumazenil in specifically selected cases. Each case should be individually considered, justified and documented within the patient's clinical record.

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